Benotti J R, Grossman W, Braunwald E, Davolos D D, Alousi A A
N Engl J Med. 1978 Dec 21;299(25):1373-7. doi: 10.1056/NEJM197812212992501.
Amrinone, a new bipyridine derivative, exerts a positive inotropic action in experimental preparations and is effective when administered orally to dogs. To assess its immediate effects in man, we studied by cardiac catheterization the hemodynamic responses to amrinone (1.85 to 3.5 mg per kilogram given intravenously) in eight patients with congestive heart failure already receiving full doses of digitalis. the following statistically significant (P less than 0.01) effects were noted: cardiac index increased from a mean +/- 1 S.D. of 1.8 +/- 0.3 to 2.6 +/- 0.3 liters per minute per square meter; peak rate of left ventricular pressure rise rose from 849 +/- 233 to 1206 +/- 456 mm Hg per second; left ventricular end-diastolic pressure fell from 25 +/- 9 to 14 +/- 7 mm Hg; pulmonary-capillary pressure fell from 28 +/- 8 to 15 +/- 4 mm Hg; and right atrial pressure fell from 12 +/- 6 to 7 +/- 5 mm Hg. Mean heart rate was unchanged, and aortic mean pressure declined slightly (86 +/- 10 to 80 +/- 7 mm Hg, P less than 0.025). No toxicity was observed. Amrinone, whose mechanism of action has not yet ben defined, warrants further study as a possible treatment for heart failure.
氨力农是一种新型双吡啶衍生物，在实验制剂中具有正性肌力作用，口服给药对犬有效。为评估其对人体的即时效应，我们对8例已接受足量洋地黄治疗的充血性心力衰竭患者进行了心导管检查，研究了静脉注射氨力农（1.85至3.5毫克/千克）后的血流动力学反应。观察到以下具有统计学意义（P小于0.01）的效应：心脏指数从平均±1标准差的每分钟每平方米1.8±0.3升增至2.6±0.3升；左心室压力上升峰值速率从每秒849±233毫米汞柱增至1206±456毫米汞柱；左心室舒张末期压力从25±9毫米汞柱降至14±7毫米汞柱；肺毛细血管压力从28±8毫米汞柱降至15±4毫米汞柱；右心房压力从12±6毫米汞柱降至7±5毫米汞柱。平均心率未变，主动脉平均压力略有下降（从86±10毫米汞柱降至80±7毫米汞柱，P小于0.025）。未观察到毒性反应。氨力农的作用机制尚未明确，作为心力衰竭的一种可能治疗方法值得进一步研究。
